Effectiveness of Casein Phosphopeptide-Amorphous Calcium Phosphate on the Prevention of White Spot Lesions: A Systematic Review and Meta-Analysis

Context: one of the most important aspects of dental profession is to consider the effectiveness of the preventive systems applied and maintain the good oral hygiene, oral health and minimize the risk of caries among the patients. a great spectrum of preventive activities and materials like fluoride applications, fissure sealants; also new technologies like casein phosphopeptide-amorphous calcium phosphate (ccp-acp) have a wide effect on preventing caries. objective: the objective of this systematic review with meta-analysis was to review systematically the clinical trials of cpp-acp complex and determine the caries preventive effects on the remineralization process. data sources: pubmed, google scholar, biomed central, cochrane oral health reviews, cochrane library, directory of open access journals, ovid medline, web of science and embase were searched up to february 2016. only articles in english were included. trials that were considered clinically and methodologically homogeneous and reported on similar outcomes were pooled for metaanalyses. the clinical studies that inspected the effects of casein derivatives in dental practice were included. in vitro studies, case reports, case series, letters to the editors, editorials, review articles and commentaries were not included for the statistical analysis but evaluated to identify the potential outcomes of the further studies. study selection: of the 3859 studies screened 92 studies were assessed for eligibility, and 22 were selected for inclusion and 11 was in the final sample for meta-analysis. systematic review was assessed and the remineralization effect of cpp-acp was demonstrated compared to placebo in the meta-analysis. conclusions: the evaluated systematic review with meta-analyses, clinical trials showed the remineralization effect of cpp-acp on early caries lesions mainly the white spot lesions (wsl’s). in vivo rct studies reveal a promising caries preventing effect, inducing remineralization and treating dentin hypersensitivity and dry mouth with the use of clinical cpp-acp application.